Transoral laser microsurgery for early glottic cancer.

Objectives. To assess the outcome of transoral laser-assisted microsurgery (TLM) with regards to local and distant tumour control, quality of voice and swallowing. Design. Retrospective review of patients with five-year follow-up period. Setting. Royal Derby Hospital Head and Neck Department. Participants. All patients undergoing TLM with a diagnosis of Tis, T1, or T2 glottic tumour following endoscopic biopsy. Main Outcome Measures. Speech, swallowing, cancer-free survival, laryngectomy-free survival, and mortality rate. Results. 22 patients were treated for early glottic carcinoma with TLM. The 5-year local control rate for T1 tumours is 89% and 56% for T2 tumours. The laryngectomy rate was 4.5%. The mortality rate from local and distant disease was 4.5% with an overall mortality rate of 22% from all causes. 40% of patients had normal voices and a further 45% had only mild or moderate voice change. At their last followup, no patients assessed had any difficulty swallowing relating to their treatment for glottic cancer. Conclusion. Transoral Endoscopic CO2 laser microsurgery is a valid technique for treating early glottic tumours.